Nursing Home/Long Term Care/Home Care/Nursing home

QuestionMy sister was recently hit by a car. She has a fractured shoulder, fractured pelvis, and had surgery on her knee. She is completely non weight bearing on the left side. She is currently in a nursing home/ rehab facility. I am concerned about her care. I have witnessed her having to wait a long as an hour just to use a bedpan. She is on a PCM unit and was left on it for over 4 hours before she got a response to her call light. I have addressed this with the administrator and don to no avail. I am being told that they meet state standards. They may on paper but this clearly is a case where they do not have the staff to care for a patient in a timely manner. If my sister needs help during lunch hour, there is only 1 aide on the floor for 31 patients. The other aides are either in the dining room or feeding someone and can not leave them unattended. How can this be problem be addressed. The nursing home is in Cincinnati oh and has a rating of 4 stars. I can not imagine how bad a 2 or 3 star home is if this place got a 4.

AnswerDear Linda,
Good afternoon. I am sorry to hear about your sister's recent accident and her complex health situation as a result. I would greatly share your concern about her care if I were in your shoes. Unfortunately what you are witnessing and your sister is experiencing is not uncommon. It does seem frequently from what I hear and have seen myself, that the state staffing requirements are rarely sufficient to adequately care for those in nursing homes and rehab facilities. There is an interesting back story to having the "rehab" component added to nursing homes. That is a fairly new development. This was done just a couple of years back. So, while I won't go into all the political details here, I will share that the elderly and disabled in nursing homes were rarely getting the attention they needed. For monetary and political reasons, short-term rehab care was given to facilities that were licensed as nursing homes. So now the patients that receive this care suffer the same lack of attention. The nursing homes have more money and business, but all the patients are not getting the attention they need. All of that to say this is not just a problem in Ohio, and your concerns are valid.

So, here are two solutions for you to consider. Some families will supplement the care that is offered by paying a private caregiver to sit next to your sisters bed and help her with whatever she needs. This would be a person that your sister or you or your pooled family members would pay directly. This is not reimbursed by Health Insurance or Medicare or Medicaid. It is an out of pocket expense. You can manage this expense by trying to determine with your sister when are her "high needs" times. That is, if she sleeps well and needs no assistance at night, you can determine when she most needs help and customize the hours for the caregiver around her needs. You can even design split shifts that would include helping her with breakfast, etc. Then if she goes to rehab for an hour or so, your caregiver would be off during that time. A couple of notes regarding this: You can hire an agency to provide the caregiver for this service. They would provide the person and if she is unavailable or calls in, they are responsible for providing a suitable replacement. So, an agency caregiver should, in theory, involve less coordinating and should be more dependable. This is not always the case. Also an agency is going to be more expensive than an individual. Many times, you can find a caregiver to pay directly through your church, word of mouth, or a family member or friend who wants a temporary part-time job. Second note regarding this: When split shifts are needed, the Caregivers sometimes are less dependable. This is because for whatever reason, history shows they will agree to do it, but for any number of reasons will call in and not make it to more shifts. So, it may be worth offering a good caregiver a full days work to make sure that she is going to show up and be committed to the income opportunity. It should be, after all a temporary expense, only as your sister needs the help. Hopefully as she is getting better, she will be able to do more herself and you can scale back on the time needed. A final note on this solution: Some nursing homes and/or rehab centers have a policy that they do not want outside caregivers there. This is because they usually don't want outside "eyes" seeing a lot of what is going on in there, or they may actually tell you it is for some other specified reason. You have the right to move your sister to a place that does allow it. And you should. Of course you can also try to get friends and family there to help with her care as "visitors" and this would not cost you anything, and would get her the help she needs. Sometimes families do a mix of both to help with the cost here. It is also nicer, most times for the patient to have familiar faces helping out rather than so many new faces all the time.

Second solution that I can offer is: A state Ombudsman. For every facility licensed by the state, there is an ombudsman that is provided to advocate for those in the facility. If you and your sister feel she is getting inferior care, then you can call the state Ombudsman's office and file a complaint and ask for a visit. These people are employed to advocate for those in facilities. They know all the laws and rights that pertain to patients and those cared in facilities and will advocate for your sister. There is no charge for this service. You can contact your states Department of Health and Hospitals and ask how to contact the Ombudsman.

In this situation, you may actually decide to do both of these things. You may choose to get a caregiver there, until you speak with the Ombudsman. The Ombudsman may solve the care issue and you may no longer need the caregiver. However, I am not sure how much the Ombudsman will be able to do. Sometimes, just the presence of this person coming in is enough to get the rehab centers attention. They do not want any deficiencies or issues and they usually make changes just because they realize that you are going to call in all forces to get changes made.

I hope this gives you some helpful ideas on changes you can make to help your sister immediately. I wish you the best as you work through this situation for her. Please do contact me back if you have further questions or if you feel I may be more helpful. You may contact me directly at ginelle_leblanc@ymail.com or again through this website. I do hope your sister has a full and complete, speedy recovery.

Expertise

I can answer questions regarding home care solutions for seniors, in home care scheduling and care giver solutions, funding sources for home care, how to find a quality Care Giver, what questions to ask when interviewing a caregiver for home care, how to solve home care problems. All things related to caring for a senior at home, and the caregivers taking care of a senior. Additionally for those who own a home care business, I can help answer questions regarding the start up and operations of a home care business for seniors.

Experience

I am a Certified Senior Advisor (CSA) accreditied to help seniors and thier families to find the best solutions for their needs. I owned and operated a Home Care service for Seniors for 6 years and was able to help nearly 1,000 families find the best caregiver match for their parents, or senior loved one. I have supervised a staff of caregivers providing care in private homes, assisted living facilities, hospitals and nursing homes. I continued in the Senior Care/Home Care Industry as Regional Director of Training for Comfort Keepers providing training and operational support to 10 offices in the Gulf South Region. I now have 12 years in this field. I now own and operate my own Senior Care Consulting business, GL Consulting, LLC (www.GLconsultingLLC.com)